Q&A: ICD-10-CM coding for acute and chronic knee injuries

Q: What is the difference between an acute and chronic knee injury and how are these conditions reported in ICD-10-CM?

A: The provider’s documentation should provide clinical details about the severity of the injury and the duration of symptoms.

An acute injury is sudden and severe, while a chronic injury develops and worsens over time. Consider the following clinical scenario:

A patient presents for right knee pain. He states this pain has been intermittent for approximately six months. He does not remember any specific incident after which it started, but he notices the pain most when going up and down stairs. He has taken Aleve with some relief, but the pain seems to be worsening.

The patient has been experiencing knee pain for six months and the pain was not brought on by a specific incident. Therefore, the patient is suffering from chronic knee pain.

Many musculoskeletal conditions result from previous injury or trauma to a site, or are recurrent conditions. Codes for chronic or recurrent bone, joint, or muscle conditions are located in Chapter 13 of the ICD-10-CM manual. For example, code M22.11 is used to report recurrent subluxation of the right patella.

Codes for acute musculoskeletal injuries are located in Chapter 19 of ICD-10-CM. For example, ICD-10-CM code S83.251A is used to report an initial encounter for a bucket-handle tear of lateral meniscus of the right knee.

If the documentation lacks specific details about the location of the injury, onset and duration of symptoms, encounter type, etc., query the provider for additional information before selecting an ICD-10-CM code.

Editor’s note: This question was answered by Lynn Anderanin CPC, CPMA, CPPM, CPC-I, COSC, senior director of coding education at Healthcare Information Services in Park Ridge, Illinois, during the HCPro webinar, “Unpack ICD-10-CM and CPT Coding for Major Joint Arthroscopies and Total Joint Replacements.”

This answer was provided based on limited information. Be sure to review all documentation specific to your own individual scenario before determining appropriate code assignment.